CPT 37294
Global 000 ActiveRvsc evsc tpvt st athr cpx 1
CPT 37294 Billing & Documentation Guide
CPT code 37294 (Rvsc evsc tpvt st athr cpx 1) is classified under Surgery (Respiratory/Cardiovascular) with a global period indicator of 000. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 18, a non-facility practice expense RVU of 433.39, and a malpractice RVU of 3.65, a total non-facility RVU of 455.04 and facility RVU of 24.37. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $15825.09, though rates vary from $13098.56 to $21606.53 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 37294, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify current NCCI edits before bundling with related codes.
Payment Status & Global Period
Active code (paid under MPFS)
Endoscopic or minor procedure with related preoperative and postoperative work performed on the same day
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 37294 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 37294
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 18 | 18 |
| Practice Expense RVU | 433.39 | 2.72 |
| Malpractice RVU | 3.65 | 3.65 |
| Total RVU | 455.04 | 24.37 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 37294
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $17817.52 | $796.37 | $16542.06 - $21606.53 | 29 |
| Florida | $15362.41 | $929.69 | $14623.14 - $15978.65 | 3 |
| Georgia | $14557.73 | $834.66 | $13658.79 - $15456.66 | 2 |
| Illinois | $14823.36 | $924.08 | $14008 - $15687.91 | 4 |
| Michigan | $14365.41 | $858.12 | $13955.09 - $14775.73 | 2 |
| North Carolina | $14184.87 | $763.88 | $14184.87 - $14184.87 | 1 |
| New York | $16944.46 | $896.82 | $14438.76 - $18077.59 | 5 |
| Ohio | $13940.34 | $807.05 | $13940.34 - $13940.34 | 1 |
| Pennsylvania | $14915.82 | $825.94 | $14005.04 - $15826.6 | 2 |
| Texas | $14969.01 | $807.21 | $13887.28 - $16025.64 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
Frequently Asked Questions, CPT 37294
What does CPT code 37294 mean? +
CPT code 37294 represents: Rvsc evsc tpvt st athr cpx 1. It's in the Surgery (Respiratory/Cardiovascular) category with a global period of 000.
What is the Medicare reimbursement for CPT 37294? +
The 2026 Medicare national average non-facility payment for CPT 37294 is $15825.09. Rates range from $13098.56 to $21606.53 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 37294? +
Surgery codes commonly use modifier 22 (increased procedural services), 50 (bilateral), 51 (multiple procedures), 52 (reduced services), 58/78/79 (staged, unplanned return, unrelated within global), 62 (co-surgeons), 80/82 (assistant surgeon), and 59 or the X{EPSU} subset for distinct procedural service.
What bundling edits apply to CPT 37294? +
No NCCI PTP edits currently on file for this code.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 1, 2026.
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